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  • Title: Management of gastric varices in the pediatric population with balloon-occluded retrograde transvenous obliteration (BRTO) utilizing sodium tetradecyl sulfate foam sclerosis with or without partial splenic artery embolization.
    Author: Saad WE, Anderson CL, Patel RS, Schwaner S, Caldwell S, Pelletier S, Angle J, Matsumoto AH, Fischman AM.
    Journal: Cardiovasc Intervent Radiol; 2015 Feb; 38(1):236-41. PubMed ID: 24798129.
    Abstract:
    It is unknown whether spontaneous gastrorenal shunts actually develop in the pediatric population. The minimum age documented in studies from Asia is 32 (range 32-44) years. This study describes three pediatric patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) for bleeding gastric varices with two of the three patients undergoing combined partial splenic embolization. The first BRTO is a selective-BRTO via a surgical splenorenal shunt (15 years old) and the other two patients underwent conventional-BRTO via a spontaneous gastrorenal shunt (8 and 14 years old). The recurrent significant bleeding that they exhibited before the combined endovascular therapy did not recur for an average of 7.1 (range 1.4-14) months. In the second patient, quantitative digitally subtracted angiography was utilized to evaluate the inline portal venous flow before and after BRTO.
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